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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Increases the inpatient hospital DRG base rate by the CMS Hospital Prospective Reimbursement Market Basket for the applicable period, as reported in the quarterly Healthcare Cost Review published by the IHS Market.
Summary: Removes the three specified DSH pools and pool payment amounts for all inpatient hospitals, state operated hospitals, and woman and infant specialty hospitals and consolidates them into Pool D for non-government and non-psychiatric hospitals licensed within the State of Rhode Island, whose Medical Assistance inpatient utilization rate exceed I.0%.
Summary: This State Plan amendment automates annual adjustments to the specified rates by tethering them to the Medicare Outpatient Prospective Payment System.
Summary: Requests an exemption pursuant to 42 CFR 455.508(f) to the regulation requiring the states Recovery Audit Contractors (RAC) not review claims older than 3 years, as well as correct theSection number.
Summary: This SPA proposes to bring Rhode Island into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This SPA proposes to bring Oregon into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
